ADHD

Question 1

psychopathology in children

Answer 1

• disorders = common
• many adult mental disorders have symptoms emerging in childhood
• symptoms of the same disorder can manifest differently from kids - adults
• must consider child’s age and developmental level

Question 2

DSM5 criteria ADHD

Answer 2

1. at least 6 inattentive and/or hyperactive, impulsive symptoms
2. at least for 6 months
3. several symptoms prior to age 12
4. several symptoms in 2+ settings
5. symptoms interfere with social, academic, occupational functioning
   * for teens/adults, >5 symptoms

Question 3

DSM5 criteria for ADHD: inattentive type

Answer 3

1. fails to give attention to detail, careless mistakes
2. trouble sustaining attention in tasks/play
3. do not seem to listen when spoken to directly
4. do not follow through instructions/fails to finish school work or other tasks
5. difficulty organizing tasks and activities
6. dislikes/avoids tasks requiring sustained mental effort
7. often loses things necessary for tasks/activities
8. easily distracted by extraneous stimuli
9. often forgetful in daily activities

Question 4

DSM5 criteria for ADHD: impulsive-hyperactive type

Answer 4

1. fidgets with hands or feet, squirms in seat
2. leaves seat in situations where remaining in seat = expected
3. runs about/climbs when it is inappropriate
   (in teens/adults = restless feelings)
4. unable to play or engage in leisure activities quietly
5. “on the go” or acting like they are driven by a motor
6. talks excessively
7. blurts out answers before question = completed
8. difficulty waiting for their turn
9. interrupts/intrudes on others

Question 5

DSM5 - specifying presentation of ADHD

Answer 5

• predominantly inattentive (ADD out of term, subsumed in this category)
• predominantly hyperactive/impulsive
• combined (most)

Question 6

prevalence and course

Answer 6

• 7.2% worldwide prevalence children <18, 4% of adults
• onset = 3-4 years old (predominantly inattentive usually identified later on)
• 3:1 male-female ratio in childhood (differences disappear in adulthood
• comorbidities: 80% have other disorder
  1. ODD
  2. CD/antisocial problems
  3. specific learning disorders
  4. mood disorders
  5. SUD in teens+adults

Question 7

ADHD myths

Answer 7

1. “people with ADHD just need to try harder”
2. “kids who can play videogames for hours cannot have ADHD”
   - kids will hyperfocus on things they are interested in
   - difficulty with regulating attention - hard to know when to focus/tune out
3. “only boys have ADHD”
   - girls often overlooked and undiagnosed
4. “kids will grow out of ADHD”
   - symptoms change over time and coping methods = developed
5. “children who take ADHD meds are more likely to abuse drugs”
   - false - opposite!

Question 8

impact of development of ADHD on life

Answer 8

refer to schema in notebook

Question 9

biological view of ADHD

Answer 9

1. genetics (75-80% variability)
   - if a parent have ADHD, child has >50% chance of having ADHD
2. brain structure
   - smaller brain volume
   - abnormalities in brain structure and/or circuitry in prefrontal cortex/amygdala/caudate/putamen/hippocampus
   - less dopamine and GABA

Question 10

environemntal view of ADHD

Answer 10

1. toxins, allergens, food additivities (minimal evidence)
2. maternal smoking
3. pregnancy + birth complications
4. social adversity
   OVERALL environment interacts with genetic predisposition

Question 11

cultural expectations and ADHD diagnosis

Answer 11

• cultural expectations may explain differential rates of ADHD diagnoses
• how?

Question 12

EBT: meds

Answer 12

stimulants
- ritalin most common
- highly effective short-term treatment
- reinforce ability to pay attention, improve on -task Bs, decrease negative Bs
- side effects: insomnia, decrease in appetite
non-stimulants
- works well for some individuals
- has not been studied as long/intensely as stimulants
MEDS MAY REDUCE SYMPTOMS, BUT DO NOT IMPROVE ALL AREAS OF FUNCTIONING

Question 13

EBT: psychological and psychosocial interventions

Answer 13

goals:
1. decrease disruptive B
2. increase academic performance
3. increase social and/or organizational skills
types
1. behavioural therapy usually recommended as 1st treatment (includes summer program)
2. organizational skills training
3. CBT for adults

Question 14

behavioural therapy: behavioural parent training/parent management

Answer 14

• focus on B and family relationship
• parent implemented

Question 15

behavioural therapy: behavioural classroom management

Answer 15

• focus on classroom B, academic performance, peer relationships
• teacher implemented

Question 16

behavioural therapy: common skills being worked on

Answer 16

1. attending rewarding
2. effective commands
3. set up structure/routines
4. time out/loss of privileges
5. planned ignoring

Question 17

EBT: OST

Answer 17

• goal: overcome academic difficulties
• teach organizational , time management and planning skills
• also effective for college students

Question 18

EBT: CBT

Answer 18

• strategies/skills to cope with core symptoms of ADHD
• organizing, planning, time management, problem solving
• cognitive reframing around situations causing distress

Question 19

stimulants vs psychological treatment

Answer 19

• MTA (multimodal treatment for ADHD study)
• refer to powerpoint, slide 25

Question 20

non EBT for ADHD

Answer 20

• biofeedback (might work)
• experimental
  1. individual therapy with child
  2. diet changes
  3. occupational therapy
  4. cognitive training

Question 21

educational accommodations

Answer 21

• note taking service
• extra time
• private testing location
• laptops/tech